{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T10:41:58Z","timestamp":1786790518793,"version":"build-2736575974"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T00:00:00Z","timestamp":1646265600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Superb microvascular imaging (SMI) has been shown to improve visualization of small vessels by suppressing global motions while preserving low\u2010flow components, such as the microvessels in the placenta. We sought to determine if SMI\u2010aided visualization of flow velocity waveforms in the spiral arteries (SA) and intravillous fetal arterioles (IVA) could predict fetal growth restriction (FGR), gestational hypertension (GH) and\/or pre\u2010eclampsia (PE).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective longitudinal study of singleton pregnancies without fetal anomaly, receiving prenatal care in one of two medical centers over a 5\u2010year period. Using SMI\u2010aided color Doppler, SA and IVA flow velocity was measured at three timepoints: 11\u2009+\u20090 to 14\u2009+\u20090, 18\u2009+\u20090 to 22\u2009+\u20096 and 28\u2009+\u20090 to 34\u2009+\u20096\u2009weeks of gestation. SA and IVA flow velocity waveforms were reported as resistance indices (RI). RI values were analyzed using multilevel modeling; individual regression curves were estimated and combined to obtain the reference intervals for SA\u2010RI and IVA\u2010RI in uncomplicated pregnancies. The primary clinical outcome was FGR and secondary outcomes were PE and GH. FGR was defined as estimated fetal weight &lt;\u200910<jats:sup>th<\/jats:sup> percentile. Student's <jats:italic>t<\/jats:italic>\u2010test was used to compare deviation from expected RI between normal and complicated pregnancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 540 pregnancies included in the analysis, 18 (3.3%) had FGR, 31 (5.7%) PE and 61 (11.3%) GH. In uncomplicated pregnancies, the SA\u2010RI decreased progressively with advancing gestation, whereas the IVA\u2010RI increased with gestational age. In the third trimester, the mean SA\u2010RI and IVA\u2010RI values were significantly higher in the FGR group compared with pregnancies that did not develop FGR, while the mean SA\u2010RI was significantly higher in PE compared with non\u2010PE pregnancies. There was no significant difference in mean SA\u2010RI or IVA\u2010RI between pregnancies with <jats:italic>vs<\/jats:italic> those without GH at any gestational age. When all three adverse outcomes were combined, SA\u2010RI was significantly higher in pregnancies with these outcomes when compared to uncomplicated pregnancies in the third trimester (mean\u2009\u00b1\u2009SD, 0.29\u2009\u00b1\u20090.12 <jats:italic>vs<\/jats:italic> 0.26\u2009\u00b1\u20090.12; <jats:italic>P<\/jats:italic>\u2009=\u20090.02). In screening for FGR using SA\u2010RI, the areas under the receiver\u2010operating\u2010characteristics curves (AUC) were 0.68, 0.73 and 0.73 in the first, second and third trimesters, respectively. The respective AUCs for IVA\u2010RI were 0.72, 0.72 and 0.73 for each trimester.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>SA\u2010RI and IVA\u2010RI, measured using SMI technology, were significantly higher in pregnancies at risk for FGR in late gestation. Larger studies are needed to determine if SA and IVA flow are reliable predictors of adverse pregnancy outcome. \u00a9 2021 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.23760","type":"journal-article","created":{"date-parts":[[2021,8,16]],"date-time":"2021-08-16T06:15:37Z","timestamp":1629094537000},"page":"350-357","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Longitudinal assessment of spiral artery and intravillous arteriole blood flow and adverse pregnancy outcome"],"prefix":"10.1002","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4340-450X","authenticated-orcid":false,"given":"A. O.","family":"Odibo","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal\u2013Fetal Medicine Morsani College of Medicine  Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U.","family":"Kayisli","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal\u2013Fetal Medicine Morsani College of Medicine  Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Lu","sequence":"additional","affiliation":[{"name":"Study Design and Data Analysis Center, College of Public Health University of South Florida  Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Kayisli","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal\u2013Fetal Medicine Morsani College of Medicine  Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Schatz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal\u2013Fetal Medicine Morsani College of Medicine  Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Odibo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal\u2013Fetal Medicine Morsani College of Medicine  Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Chen","sequence":"additional","affiliation":[{"name":"Study Design and Data Analysis Center, College of Public Health University of South Florida  Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Bronsteen","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2013Fetal Medicine, Department of Obstetrics and Gynecology Oakland University William Beaumont School of Medicine, Beaumont Hospital  Royal Oak MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. 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